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Respiratory Physiology > Physiology revision > Flashcards

Physiology revision Flashcards

1
Q

What spirometry results would you expect to find for a patient with COPD?

A

Decreased or normal FVC
Decreased FEV1
Decreased FEV1/FVC %

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2
Q

What spirometry results would you expect to find for a patient with interstitial lung disease?

A

Decreased FVC
Decreased FEV1
Normal FEV1/FVC%

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3
Q

What spirometry results would you expect to find for a patient with a combination of restrictive and obstructive lung disease?

A

Decreased FVC
Decreased FEV1
Decreased FEV1/FVC%

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4
Q

What is Boyle’s Law?

A

At any constant temperature, the pressure exerted by a gas varies inversely with the volume of the gas.

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5
Q

“As the volume of a gas increases, the pressure exerted by the gas decreases”. Who’s Law is this?

A

Boyle’s Law

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6
Q

What are the four steps of external respiration?

A

Ventilation
Gas exchange between alveoli and blood
Gas transport in blood
Gas exchange at tissue level

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7
Q

What two factors hold the thoracic wall and the lungs in close opposition?

A

The intrapleural fluid cohesiveness

The negative intrapleural pressure

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8
Q

What does the “intrapleural fluid cohesiveness” mean?

A

Water molecules in intrapleural fluid are attracted to each other and resist being pulled apart. Therefore, the pleural membranes stick together.

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9
Q

What does the “negative intrapleural pressure” mean?

A

The sub-atmspheric intrapleural pressure creates a transmural pressure gradient across lung wall and across chest wall. Therefore, the lungs are forced to expand outwards and the chest forced to squeeze inwards.

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10
Q

What is the average value for atmospheric pressure?

A

760mmHg

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11
Q

What is the average value for intra-alveolar pressure?

A

760mmHg

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12
Q

What is the average value for intrapleural pressure?

A

756mmHg

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13
Q

What nerves supply the diaphragm?

A

The phrenic nerve from cervical nerves 3, 4 and 5

C3, C4, C5

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14
Q

Is inspiration an active or passive process?

A

Active

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15
Q

Is normal expiration an active or passive proocess?

A

Passive

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16
Q

In a pneumothroax, what happens to the intrapleural pressure?

A 
It rises (to 760mmHg)
(Not 756mmHg anymore)
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17
Q

What is alveolar surface tension?

A

Attraction between water molecules at liquid air interface.

Produces a force which resists the stretching of the lungs.

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18
Q

What is the Law of LaPlace?

A

“The smaller the alveoli, the higher the tendancy for the alveoli to collapse.”

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19
Q

Which law states that alveoli with a smaller radius are more likely to collapse than alveoli with a larger radius?

A

The Law of LaPlace

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20
Q

What does pulmonary surfactant prevent?

A

The collapse of alveoli

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21
Q

What is pulmonary surfactant a mixture of?

A

Lipids and proteins

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22
Q

What is pumlonary surfactant secreted by?

A

Type II alveoli

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23
Q

How does pulmonary surfactant prevent collapse of alveoli?

A

PUlmonary surfactant lowers surfac tension of alveoli by interspersing between the water molecules lining the alveoli.
(Lowers surface tension of smaller alveoli more than that of large alveoli)

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24
Q

What is respiratory distress syndrome of the new born caused by?

A

Lack of pulmonary surfactant

because of premature birth

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25
Q

According to alveolar interdependence, what happens if an alveolus starts to collapse?

A

The surrounding alveoli are stretched and then recoil, exerting expanding forces in the collapsing alveolus to open it.

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26
Q

What are the muscles of active respiration?

A

Internal intercostal muscles

Abdominal muscles

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27
Q

What is the value for:

Tidal Volume?

A

500ml

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28
Q

What is the value for:

Inspiratory reserve volume?

A

3000ml

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29
Q

What is the value for:

Inspiratory capacity?

A

3500ml

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30
Q

What is TV + IRV?

A 
Inspiratory capacity
(500+3000=3500)
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31
Q

What is the value for:

Expiratory reserve volume?

A

1000ml

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32
Q

What is the value for:

Residual volume?

A

1200ml

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33
Q

What is the value for:

Functional Residual Capacity?

A

2200ml

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34
Q

What is ERV + RV?

A

Functional Residual volume

1000 + 1200 = 2200

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35
Q

What is the value for:

Vital Capacity?

A

4500ml

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36
Q

What is the value for:

Total lung capacity?

A

5700ml

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37
Q

What is VC + RV?

A

Total lung capacity

4500 + 1200 = 5700

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38
Q

What is IRV + TV + ERV?

A 
Vital capacity
(3000 + 500 + 1000 = 4500)
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39
Q

VC =

A

IRV + TV + ERV

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40
Q

TLC =

A

VC + RV

IRV + TV + ERV + RV

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41
Q

IC =

A

TV + IRV

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42
Q

FRC =

A

ERV + RV

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43
Q

What is pulmonary compliance a measure of?

A

The effort that has to go into stretching or distending the lungs.

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44
Q

What causes decreased pulmonary compliance?

A 
Pulmonery fibrosis
Pulmonary oedema
Lung collapse
Pneumonia
Absence of surfactant
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45
Q

What symptoms do patients with decreased pulmonary compliance present with?

A

Dyspnoea

46
Q

Pulmonary compliance increases/decreases with age.

A

Increases

47
Q

What happens if pulmonary compliance increases too much?

A

The elastic recoil of the lungs is lost

48
Q

Increased pulmonary compliance is seen in:

A

Emhysema

49
Q

With increased pulmonary compliance, patient have to work harder to..

A

Get air out of the lungs

50
Q

How do you work of pulmonary ventilation (L/min)?

A

Tidal volume x Respiratory rate

51
Q

What is the value for average pulmonary ventilation under resting conditions (L/min)?

A

6L/min

52
Q

What is pulmonary ventilation?

A

The volume of air breathed in and out per minute

53
Q

Why is alveolar ventilation less than pulmonary ventilation?

A

Because of the presence of anatomical dead space

54
Q

How do you work out alveolar ventilation (L/min)?

A

(Tidal volume - Dead space) x Respiratory rate

55
Q

What is alveolar ventilation?

A

The volume of air exchanged between the atmosphere and the alveoli per minute

56
Q

What is anatomical dead space?

A

Areas of respiratory tract containing air that does not reach the alveoli and is therefore not involved in gas exchange between the atmosphere and the alveoli.

57
Q

What is alveolar dead space?

A

Ventilated alveoli which are not adequately perfused with blood.

58
Q

What is physiological dead space?

A

Anatomical dead space x Alveolar dead space

59
Q

What is ventilation the rate of?

A

The rate at which gas passes through the lungs

60
Q

What is perfusion the rate of?

A

The rate at which blood passes through the lungs

61
Q

Sympathetic stimulation causes bronchodilation/bronchoconstriction.

A

Bronchodilation

62
Q

Parasympathetic stimulation causes bronchodilation/bronchoconstriction.

A

Bronchoconstriction

63
Q

Bronchodilation is caused by sympathetic/parasympathetic stimulation.

A

Sympathetic

64
Q

Bronchconstriction id caused by sympathetic/pararsympathetic stimulation.

A

Parasympathetic

65
Q

When oxygen is decreased, the pulmonary arterioles vasodilate/vasoconstrict.

A

Vasoconstrict

66
Q

When oxygen is decreased, the systemic arterioles vasodilate/vasoconstrict.

A

Vasodilate

67
Q

When oxygen is increased, the pulmonary arterioles vasodilate/vasoconstrict.

A

Vasodilate

68
Q

When oxygen is increased, the systemic arterioles vasodilate/vasoconstrict.

A

Vasoconstrict

69
Q

Which four factors influence the rate of gas exchange across an alveolar membrane?

A

Partial pressure gradient of oxygen and CO2
Diffusion coefficient for O2 and CO2
Surface area of alveolar membrane
Thickness of alveolar membrane

70
Q

What is Dalton’s Law of Partial Pressure?

A

The total pressure exerted by a gaseous mixture = the sum of the partial pressures of each individual component in the gas mixture

71
Q

What is PAO2?

A

Partial pressure of O2 in alveolar air

72
Q

What is PiO2?

A

Partial pressure of O2 in inspired air

73
Q

PaCO2

A

Partial pressure of CO2 in arterial blood

74
Q

What is the value of the respiratory exchange ratio?

A

0.8

75
Q

What is the respiratory exchange ratio?

A

The ratio of CO2 produced/O2 consumed

0.8

76
Q

What is the O2 partial pressure gradient in pulmonary capillaries?
(from alveoli to blood)

A

60mmHg

77
Q

What is the CO2 partial pressure gradient is pulmonary capillaries?
(from blood to capilaries)

A

6mmHg

78
Q

What is the O2 partial pressure gradient in systemic capillaries?
(blood to tissue cells)

A

> 60mmHg

79
Q

What is the COs partial pressure gradient in systemic capillaires?
(tissue cells to blood)

A

> 6mmHg

80
Q

Why is thee partial pressure gradient so much higher for O2 than CO2?

A

Because the diffusion coefficient is (20 times) higher for CO2 than O2.
(solubility of gas in membrane, much higher for CO2 than for O2)

81
Q

A big gradient between PAO2 and PaO2 would indicate:

A

Problems with gas exchange in the lungs
or
A right to left shunt in the heart

82
Q

What is Fick’s Law if Diffusion?

A

“The amount of gas that moves across a membrane in unit time is proportional to the area of the sheet but inversely proportional to its thickness”

83
Q

Which law states that as thickness of a membrane increases, the amount of gas moving across is decreases?

A

Fick’s Law of Diffusion

84
Q

Which law states that as the area of a membrane increases, the amount of gas moving across it increases?

A

Fick’s Law of Diffusion

85
Q

Under resting conditions, how much oxygen is taken to the tissues as dissolved O2?

A

15ml/min

86
Q

At strenuous exercise, how much oxygen is taken to the tissues as dissolved O2?

A

90ml/min

87
Q

What is the resting oxygen consumption of our body cells? (ml/min)

A

(approx.) 250ml/min

88
Q

How many haem groups does each haemoglobin contain?

A

4

89
Q

What is DO2I?

A

Oxygen Delivery Index

90
Q

What is CaO2?

A

Oxygen Content of arterial blood

91
Q

What is CI?

ci

A

Cardiac index

92
Q

How do you determine the oxygen delivery index?

A

DO2I = CaO2 x CI

93
Q

How much O2 does one gram of haemoglobin carry when fully saturated?

A

1.34ml

94
Q

How do you determine the oxygen content of arterial blood?

A 
CaO2 = 1.34 x (concentration of Hb) x SaO2
(1.34 = how much oxygen one gram of Hb carries when fully saturated)
(SaO2 = % Hb saturated with oxygen --- determined by PO2)
95
Q

What is thee pressure of the water vapour in the respiratory tract?

A

47mmHg

96
Q

What is co-operativity with regards to Hb?

A

Binding of one O2 to Hb increases the affinity of Hb for O2

97
Q

What is the Bohr Effect?

A

Shift of (dissociation) curve to the right

98
Q

What is the name of the effect when the (dissociation) curve shifts to the right?

A

The Bohr Effect

99
Q

Foetal Hb has a higher/lower affinity for O2 than adullt Hb

A

Higher

100
Q

The foetal (dissociation) curve is shifted to the left/right compared to the adult curve

A

Left

101
Q

Myoglobin has ___ haem group(s).

A

1

102
Q

Myoglobin provides a shirt-term storage of O2 in which conditions?

A

Anaerobic

103
Q

The presence of myoglobin in the blood indicates

A

Muscle damage

cardiac or skeletal

104
Q

The rhythm of breathing is generated by a network of neurons called the..

A

Pre-Botzinger complex

105
Q

What respiratory group of neurons are excited by the pre-botzinger complex and then fire in burts, causing contraction of inspiratory muscles?

A

Dorsal respiratory group neurons

106
Q

What respiratory group neurons are excited by increased firing of dorsal neurons?

A

Ventral respiratory group neurons

107
Q

Stimulation of the _______ centre terminates inspiration.

A

Pneumotaxic centre

108
Q

The pneumotaxic centre is stimulated when _____ respiratory neurons fire

A

Dorsal respiratory neurons

109
Q

Breathing rhythm generated in the…

A

Medulla

110
Q

Breathing rhythm can be modified by inputs from…

A

Pons

111
Q

What is the Hering Breuer reflex?

A

Afferent discharge (pulmonary stretch receptors) inhibits inspiration

112
Q

What do chemoreceptors do?

A

Sense the valus of the gas tensions

Respiratory Physiology (2 decks)

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